Neuropathy
Diabetic neuropathy is one of the symptoms of prolonged hyperglycemia. It causes numbness and weakness in the legs, particularly in cats. See also gastroparesis, which is a neuropathy of the stomach, and retinopathy, which is a neuropathy of the eye. Symptoms In diabetic neuropathy, nerves in the legs are progressively damaged, leading to tingliness, pain, numbness, and weakness or paralysis. Symptoms are less common in dogs, but do occur. Many dogs have hind leg weakness when they are first diagnosed with diabetes. This is sometimes the symptom which brings the pet to the vet's office. It's often falsely attributed to "getting older" by the caregiver. What is also known as "diabetic neuropathy". most often affects both rear legs and will progress symmetrically. With treatment and regulation, most dogs also have reversal of neuropathy This 1983 JAVMA abstract indicates that both the neuropathy and low blood pressure returned to normal following the control of the diabetes with insulin. It's also possible to have peripheral neuropathy as a result of continuing hypoglycemic episodes. Mechanics of diabetic neuropathy In humans, the excess glucose oxidizes the tiny capillaries that nourish nerve cells, and the resulting constriction starves the nerve cells. (See Wikipedia:Diabetic Neuropathy link below. Wikipedia:Diabetic neuropathy) In dogs and cats the mechanism seems different: the nerve axons dwindle and atrophy, and the spaces between them become clogged with glycogen deposits. Understanding how this works, means some learning about nerve cells, impulses and their relationship to muscles. An Atlantic Coast Veterinary Conference (ACVC) 2001 presentation of feline neurological diseases has a section dealing with diabetes-mediated neuropathy. The basic problems regarding nerves, muscles and neuropathy apply to all those with diabetes, so let's take it apart: The most common neuropathy noted in the feline is diabetic neuropathy (secondary to diabetes mellitus). Clinical signs occur most commonly in the middle to older aged feline and present as lower neuron signs (plantigrade stance) in the hind limbs. Patellar (of the knee) reflexes may be diminished, although flexor Biology Pages: Muscle Spindles}} reflexes and pain sensation are usually intact. Muscles and nerves can't communicate properly The etiology and pathogenesis of diabetic neuropathy involves primary and secondary axonal (nerve fiber) degeneration due to slowing of axon transport (Neuron impulses move along axons very much like electricity through a wire . Flaws in this communication system between nerves and muscles are the basis for neuropathy and other nerve-related disorders, such as Muscular Distrophy, etc.) secondary to [[hyperglycemia], alteration of macromolecular transport, interference with axon maintenance and repair by the neuronal cell body, and neural hypoxia (Insufficient oxygen--in this case to the neuron). A gradual state Progression to this state may occur over several months. Diagnosis and treatment is through the establishment of underlying disease (diabetes mellitus) and characteristic neurologic exam findings, and in most cases will resolve in 6 to 12 months if the DM is treated appropriately. Those who have a disease or diseases of the endocrine system (medical catch-all term is endocrinopathy) are more prone to neuropathic problems than anyone who has no endocrine conditions. Peripheral and other neuropathies This type of neuropathy is known as peripheral neuropathy. There are more types of neuropathies which can affect diabetics--all nerves throughout the body can be at risk. Insulin Neuritis There is a form of neuropathy which has been known to doctors treating people with diabetes since the advent of insulin therapy. The name given to it is insulin neuritis, as it often occurs shortly after starting insulin. The problem is that even though it's been around about as long as insulin treatment, the phenomenon is currently not considered common. Insulin neuritis can follow the rapid improvement of diabetic control, but its mechanisms are still elusive As you see from this link, one theory is that insulin neuritis is caused by the regeneration of the nerve axons. Like the neuropathy which is the result of yet-to-be treated or newly diagnosed diabetes, insulin neuritis also requires time to disappear. References More Information *Perineurial Abnormalities in the Spontaneously Diabetic Dog Ghani M, Malik RA, Walker D, Sharma AK, Lowrie CT, Schall WD, Boulton AJ., 1999, Acta Neuropathologica *Electrodiagnostic Analysis of Peripheral Neuropathy in Dogs with Diabetes MellitusSteiss JE, Orsher AN, Bowen JM., 1981, American Journal of Veterinary Research Study with long-time diabetic dogs has findings similar to those of humans--that long-term diabetes tends to mean some neuropathy. *Peripheral Neuropathy--Diabetes and Non-Diabetes Related Southpaws *Definition of Perineurium Dorland's Medical Dictionary *Clinical peripheral neuropathy associated with diabetes mellitus in 3 dogs Morgan MJ, Vite CH, Radhakrishnan A, Hess RS., 2008, Canadian Veterinary Journal Category:Conditions Category:Complications Category:Tips Category:Symptoms Category:Terms Category:Content